Family Resource Sheets for 15 Month Well Visit

Your 15-month-old will continue to explore and demand his independence in the next few months. He will spend all day experimenting! He will start to run everywhere rather than walk, and his excitement as he explores overwhelms whatever limited impulse control he has.  As he becomes more independent, a key part of your job is to balance his independence with helping him make good choices. When possible, let him choose between two options. But make sure both options are good ones.

Your toddler will suddenly seem to understand everything you say. You’ll announce lunchtime and he’ll be waiting by his high chair. You’ll tell him you’ve lost your shoe and he’ll find it. At first, his rapid response may seem a little unusual. Did he really understand, or is this just a dream? Rest assured, it’s not your imagination. Your 15-month-old is becoming quite independent these days.

Be aware of fears. Young children are more aware of changes in their surroundings and the important people in their lives. This is normal, and with your support, helps your child learn how to deal with changes. When a child feels scared or anxious of someone he doesn’t know, this is called stranger anxiety. He may also feel nervous about someone he does know if it means being separated from his parents. This is called separation anxiety. Some children are slow to warm up to others. These children may be cautious and quiet. Other children are very outgoing with new people. They may be friendly or even aggressive by hitting or biting.

Your toddler will need to be around peers in the next few months - it is how he learns to interact in this world.  It is a critical time to get your toddler out of the parent-child cocoon and into the rough-and-tumble world of other children. One or two regular playmates are enough. However it is okay if he doesn’t engage other children in “play”. Instead he may just play alongside.  he’ll enjoy watching and being around other children, especially if they’re slightly older. He may imitate them or treat them the way he does dolls, for example, trying to brush their hair, but he’s usually surprised and resists when they try to do the same thing to him . He may offer them toys or things to eat but may get upset if they respond by taking what he’s offered them.

Your 15-month-old is probably starting to say a few words.  his language development will continue to grow over the next few months.  however, do not be concerned if your child is not saying much yet. Boys generally develop language skills more slowly than girls. As your child begins to speak more, his first few words probably will include the names of familiar people, his favorite possessions, and parts of his body.

You may also be discovering that your 15-month-old has a temper.  Your toddler may get easily frustrated these days. Watching for the signs of a meltdown and taking steps ahead of time can be easier than trying to deal with a child who has lost his temper.

• Distract when possible. When your child begins to get frustrated with one activity or is mad that you won’t let him have something he wants, move him to something else he’ll think is fun.
• Give him some control. One of a toddler’s frustrations is that he wants to do things on his own, but he can’t. Give him control in safe areas, like turning pages on a book as you read.

You can talk to your child’s health care provider about behaviors to expect in the next few months.

• What kind of key behaviors can I expect from my child in the next few months?
• The temper tantrums have already started! What is the best way to deal with my child when he is frustrated?
• My child has started biting me and his playmates. How should I handle this?
• My child has been so outgoing and now he has extreme separation and stranger anxiety – why has this started again?

Managing Temper Tantrums: Getting a Head Start at the 15 Month Visit (AAP)

Talking and Your Toddler: Communication and Social Development (AAP)

Your Child's Development: 15 to 18 Months (Zero to Three)

Growth Milestones: 15 Months (KidsHealth)

American Academy of Pediatrics (AAP) Healthy Children. http://www.healthychildren.org/English/Pages/default.aspx. Accessed 4/1/2010

AAP Bright Futures. Managing Temper Tantrums: Getting a Head Start at the 15 Month Visit. Retrieved 4/1/2010 from http://www.healthyfuturesva.com/Text.aspx?html=v10_tantrums&type=snapshot

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

The 15-month-old is able to move around under his own power—either by crawling or walking—and often discovers how much fun that can be. This is an age at which you should encourage your toddler's autonomous behavior, curiosity, sense of emerging independence, and feeling of competence. At the same time, you’ll be providing clear guidance about appropriate limits of safe and socially acceptable behavior.

The earlier you begin promoting your child’s sense of independence, the better!  You can do this by giving him safe areas in the house to explore and play in and by giving him a choice between two options (both of which are acceptable to you).  It is equally as important to be setting clear boundaries as your 15-month-old begins to “test” you to see what he can get away with.

With the wonderful surge in independence and the comprehension that exploration brings, a toddler is bound to develop all kinds of fears.  You might find that your child will swing back and forth constantly between fierce independence and clinging to you. Brief separations from you may help your toddler become more independent. He’ll still suffer some separation anxiety and perhaps put up a fuss when you leave him—even if it’s just for a few minutes. But the protest will be brief. 

Protest is a healthy way for your child to handle separations.  It is correlated with the strength of his will and his confidence to assert himself .   First, start preparing your child ahead of time about an impending separation.  For example, you might say, “I am going to do some errands.  I'll be home before your snack, and then I’ll show you what we bought!”  Second, you should be ready to accept a healthy outburst.  Third, you should promise to return, and upon doing so, remind him that you did return.  This is the basis of future trust.  Remember, chances are, you may be more upset by these separations than he is, but try not to let him know that. If he believes his fussing has a chance of getting you to stay, he’ll learn to continue this behavior.

You can talk to your child’s health care provider about encouraging your child’s exploration while keeping him safe as he grows more independent from you.

• One minute my 15-month-old has disappeared around a corner, and the next he’s frantic to find me. What is going on?
• Is it okay to leave my 15-month-old alone in his room to play by himself ?

Talking and Your Toddler: Communication and Social Development (AAP)

How I Grow in your Care: Eight to Eighteen Months (KidsHealth)

American Academy of Pediatrics (AAP). Emotional Development: 1 Year Olds. Retrieved 4/1/2010 fromhttp://www.healthychildren.org/English/ages-stages/toddler/Pages/Emotional-Development-1-Year-Olds.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

As your 15-month-old becomes more independent, an important job for you now is to balance his independence with helping him make good choices. When possible, let him choose between two options. But make sure both options are good ones. Allowing him to make choices will help him feel more in control and role model positive behaviors and decision-making. It may also help to reduce power struggles.

A great place to give your child the choice between to acceptable options is with food. Learning to make good food choices is an important life skill.  “Do you want banana or applesauce?” “Do you want more or are you all done?” This allows for guided practice—and confidence building—so your child begins to learn that his preferences count, and to make good choices on more important issues.

Allowing him to make choices in some areas will decrease power struggles in others. As parents and caregivers, you can provide a choice of healthy foods and let your toddler decide which of those he prefers.
 
You can talk to your child’s health care provider about giving your child a choice between options.

• Sometimes I don’t care whether my child wears a red shirt or a green one, but sometimes it does matter. How can I help my child understand that sometimes he can’t be the one to make the decisions?
• Sometimes we’re in a hurry and can’t always let my baby make the choices. Is this okay?

Talking and Your Toddler: Communication and Social Development (AAP)

Growing Independence: Tips for Parents of Young Children (AAP)

Toddlers at the Table: Avoiding Power Struggles (KidsHealth)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Children this age are very aware of who the familiar people are in their lives – and who is new or different. New people or new situations may make your child anxious.  This is normal, and with your support, helps your child learn how to deal with changes. While your child enjoys being more independent, he is not yet comfortable with the idea that he is an individual and separate from you. 

Whether it’s grandmother visiting from another state or a new teacher at childcare, you can help your child become at ease with new people by being reassuring and giving him time to warm up.  Sometimes it’s helpful to say this to the new person too, so they’ll understand what’s typical of 15-month-olds. When introducing your child to someone new, even a family member, always stay close so he feels safe.  Avoid telling your child to act like a big boy as that will only make him feel and act more needy. Do not force him to talk to people who scare him , such as Santa Claus or clowns. Give him time to warm up to new people.

You can help your child learn about the world! Brief separations from you may help your toddler become more independent. He’ll still suffer from separation anxiety and perhaps put a fuss when you leave him, even if it’s just for a few minutes. But the protest will be brief.  Whatever his behavior, try not to overreact by scolding or punishing him . The best tactic is to reassure him before you leave that you will be back and, when you return, to praise him for being so patient while you were gone.  This will help your child understand that you always return and continue to love him and he’ll feel more secure.

You can talk to your child’s health care provider about how your child responds to new people.

• How can I help family members understand the importance of taking it slowly during this phase?
• How do you balance teaching a toddler to be wary of strangers and at the same time be friendly?

Soothing Your Child's Separation Anxiety (AAP)

Separation Anxiety (KidsHealth)

American Academy of Pediatrics (AAP). Emotional Development: 2 Year Olds. Retrieved 4/1/2010 fromhttp://www.healthychildren.org/English/ages-stages/toddler/pages/Emotional-Development-2-Year-Olds.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

Reading helps with language and speech development, which will be especially important for your child over the next year.  It’s not just the story itself that’s important, but how your child becomes engaged with it.  It’s okay to read the same story many, many times.  Children this age are learning to love repetition – they love when they can anticipate what will happen next. 

You don’t have to be a great reader to share books. Look at the pictures and talk about them together. Stop throughout the story to ask your child questions – “Where’s the big dog?” “See, it’s raining – does the little boy have an umbrella?” You can also see what your child is interested in and can then talk about those things, such as fire trucks or babies, and relate them to your child’s life, beyond what is in the story – “Yes, that’s a baby like Aunt Kathy’s baby, Maya.”  All of this promotes language development. 

And because reading involves physical closeness, as you hold your child on your lap or sit next to her, it strengthens the bond you have with your child. Interesting things to look at, love and individual attention – what could be better?!  Reading to your child has so many benefits – try to do it every day.

You can talk to your child’s health care provider about ways to read to your child that promote language development.

• What are age-appropriate books for a 15- month old child?
• How often should I read to my child?
• I feel like we’re reading the same story over and over and over. Is this okay? Should I vary the stories more?
• We don’t always make it through some of the books we read –does that matter?

Literacy and Language: Developing Your Child’s Skills (AAP)

Toddler Reading Time (KidsHealth)

Importance of Reading Aloud (Reach Out and Read)

Reading Tips for Parents and Educators (KidsHealth)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your 15-month-old might be using some simple words yet understanding many more.  He might be able to say things like “ball” and “dog” although not all of his new words are coming out completely clear yet.  Using brief, clear, specific words and gestures over and over will help your toddler better understand what you are saying and feel like he can try to use them too, such as “eat,” “shoe,” “more milk.” When he speaks and you understand him , repeat the words. He’ll feel pleased about having made his point. Communicating and being understood is a universal need.

When your child talks, repeat what he says often so that he experiences being heard.  Respond to the meaning and not the exact words that are spoken. Ask questions and wait for an answer. Don’t focus on correcting the words. Language development is enhanced by giving kids questions to answer and time to respond.

Using simple words and phrases is also important when asking your child to do something or giving directions. Tasks that seem simple, like getting dressed in the morning, actually have many steps.  If your child “can’t” or “won’t” do something, it may be that he still needs to learn the steps.  Explain steps one at a time and then offer praise.  For example:

1. “Please go get that ball.  It is by the couch.”
2. “Ok, now bring the ball to the toy basket.”
3. “Now put it in the basket.”
4. “Thank you!  You did a good job helping clean.”

Take time to remind your child about each step rather than just doing it yourself or getting upset.  It will take longer at first but is well worth it for you and your child! Other things you can to do help promote your child’s language development include:

• Talking to him about what you are doing. “I’m going to wash the clothes. Do you want to help me put clothes in the basket?”
• Singing songs together. Old favorites and new are welcome!
• Playing word games. Soon you can say, “Where’s your nose?” And though he can’t say “nose,” he will be able to point to his .
• Describing how your child feels. “I know you feel frustrated that the blocks won’t stack the way you want them to.”

You can talk to your child’s health care provider about the importance of using simple words, asking simple questions and repeating what you heard from your child.

• What can my child understand right now?
• Sometimes we use words my baby says, like “wa” for water. Some people say that’s not a good idea – what’s right?

Language Development: 1 Year Olds (AAP)

Article: Your child's language and brain development (BabyCenter)

How Babies Communicate (KidsHealth)

American Academy of Pediatrics (AAP) Bright Futures. Talking and Your Toddler: Communication and Social Development. Retrieved 4/1/2010 from http://www.healthyfuturesva.com/Text.aspx?html=v10_communication&type=snapshot

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Parenting is a 24/7 job—even when you aren’t actually with your child, you are still responsible for his well-being. A key part to a child being happy and healthy is having a parent whose own needs are met.  Where do you and YOUR interests and other responsibilities fit in? Now that your child is a busy bee and is more demanding of your attention, it’s natural for you to need help sometimes. Striking a balance between finding a way to meet the needs of your child without ignoring your own needs is important and is often a challenge.

It is important to find a balance that ensures that the child’s needs are met, and the parent still feels like they they have a life as well. Remind yourself of all the interests and things you did before your child was born! Schedule some time for yourself – whether to take a walk, attend a class, get together with friends – and take it seriously.  Maybe you’d like to develop some new interests and skills? Learn what’s available in your community – check at the library or in the newspaper or through adult education sources.  Also, don’t forget your own health appointments.

You can talk to your child’s health care provider about how to balance taking care of yourself while being a parent if you have any concerns about this. Your child’s health care provider sees many parents and may know about different strategies that other parents use to balance meeting their child’s needs while meeting their own.

• Sometimes I get so angry at my 15-month-old I could scream—or worse. I don’t want to hurt him . What can I do to stay calm?
• I work full-time and feel guilty getting a babysitter on the weekend in order to have some me-time, how do I find a balance?
• I have a child with special needs and I really don’t trust his care to anyone else. How can I find qualified help?

Talking and Your Toddler: Communication and Social Development (AAP)

Parenting: Being supermom stressing you out? (APA)

Parenting: Fatherhood and healthy family behaviors (APA)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your 15-month-old is growing, but he still needs lots of sleep. In fact, regular naps and a set bedtime and bedtime ritual are as important as ever. For some children, one nap each day may now be enough and it should take place early in the afternoon so as not to affect bedtime.

Changes in routines, learning a new skill (like walking), or teething may cause night waking and fussing again.  If your child awakens during the night, check on his safety and comfort and use a favorite toy or security object. Have as little interaction as possible, and put him back to bed as soon as possible. Try to avoid offering a bottle or nursing. Children this age do not need to eat during the night.  At this age, it is OK to let him cry himself to sleep.  Some good news is that after walking is achieved, a child is usually ready to sleep through the night again.

Many toddlers don’t look forward to going to sleep because it means missing out on the action, separating from the parent, and facing nighttime on his own. Keeping to a regular routine for naps and sleep can be a great help. Having a routine helps your child learn what is expected and when. If you have trouble finding a sleep routine that works for you and your child, tell his doctor.

Put your little one to sleep at the same time each night in his room. He should be drowsy, but not asleep when you put him in his crib. Try to get your child to go to bed without a bottle.  If he must have one to fall asleep at nap time or bedtime, just give him water in it. Also, avoid bringing him into bed with you as a way to get back to sleep. Your toddler needs to learn to fall asleep by himself .

You can talk to your child’s health care provider about sleep routines and sleep habits.

• How should I deal with my child waking in the night? Is it okay to let him cry himself to sleep?
• Every now and then we’re short on time. What should I do in that case – put him to bed late for the routine or rush through to get to bed on time?

Toddler Bedtime Trouble: Tips for Parents

Toddler Bedtime Trouble: 7 Tips for Parents (AAP)

Sleep and Your 1-2-Year-Old (KidsHealth)

American Academy of Pediatrics (AAP) Bright Futures. Sound Sleep Advice at the 15 Month Visit. Retrieved 4/1/2010 from http://www.healthyfuturesva.com/Text.aspx?html=v10_sleep&type=snapshot

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

No matter how much you love your child, night wakings are a test of your patience and energy and is one of the most common issues families bring up at their child’s well-visit. Some children at this age, even though they have been sleeping well, may go through a short period of night waking. If he wakens, do not give him enjoyable attention; a brief visit with reassurance from you is all that is needed for him to return to sleep. Provide your child with a stuffed animal, blanket, or favorite toy that he can use to help console himself at bedtime, should he wake. Also, you should not give him a bottle to sleep with, or bring him into bed with you as a means to get him back to sleep.

Here are a few more tips for preventing and dealing with night waking and fussing:

• Keep a consistent daily routine and do quiet activities to lead up to bedtime.
• Continue to put him to sleep when he is drowsy but still awake so he can stay in the habit of falling asleep on his own.
• Wait just a few minutes before responding if he is fussing to see if he will go back to sleep on his own. If he continues to cry, check on him , but don't turn on the light, play with him or pick him up. If he gets frantic or is unable to settle himself , consider what else might be bothering him . He may be wet or soiled, feverish or otherwise not feeling well. As tempting as it may be to calm him down with food or cuddling, he’ll learn and come to expect these responses when he wakes up at night and won’t go back to sleep without them.
• Also, don’t feed him unless you have a reason to believe he’s really hungry (e.g,. if he feel asleep earlier than usual and missed a meal).
• Limit each daytime nap to no longer than 3 hours a day.

You can talk to your child’s health care provider about night waking and fussing and strategies for dealing with it.

• Lately my child has been waking up again and crying for me. I’m not sure what he needs. Do I go to him or let him cry?
• Why is my child waking in the night again after sleeping through the night for the past few months/weeks?
• How can I deal with my child’s night waking and fussing?

Toddler Bedtime Trouble: 7 Tips for Parents (AAP)

Toddler Bedtime Trouble: Tips for Parents

American Academy of Pediatrics (AAP). Getting Your Baby to Sleep. Retrieved 4/1/2010 fromhttp://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Getting-Your-Baby-to-Sleep.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Life is rapidly changing for a 15-month-old! Everyday your child is learning new things and trying his best to imitate the exciting things others are doing. Sometimes he isn’t able to do those things - and sometimes people prevent him from trying if it’s something he’s not supposed to be doing. No wonder your 15-month-old gets frustrated! And that frustration can lead to temper tantrums—one of the skills your child still needs to learn is how to cope with frustration in a more productive way. 

Sometimes the best way to stop a tantrum is by preventing it in the first place.  Watch your child for signs that a tantrum might be brewing and look for something to get his mind off the frustration.  While teaching him other ways to respond, there’s also nothing wrong with distracting him at times, or trying another approach. As long as you’re not “bribing” him to behave differently by offering him sweet snacks, for example, there’s nothing wrong with intentionally changing his focus.  A hug, a change of scenery, a nutritious snack can all be positive ways to ward off the tantrum. Make sure your child gets the rest he needs to make it through the day. Make outings with your child short with few stops. Give your child choices as often as you reasonably can—making sure that you are okay with the options you offer.

All prevention efforts aside, temper tantrums around this age are likely inevitable.  Temper tantrums are due to your toddler’s basic struggle to master the intensity of his own feelings.  Only he can resolve the indecision that causes them, though he can learn ways to settle himself down from modeling on his parents’ unruffled response to his tantrums.  After he has learned to handle this struggle, he’ll be a stronger and more secure child.

First, remember your options, all directed at leaving it up to the child.  Either pick him up to hold him quietly, gather him to carry him to a safe spot where he can work it out himself , or – if he’s in a safe place – walk out of sight momentarily.  When he can’t see you, the tantrum will lose force.  Then quickly return to say, “I’m sorry I can’t help you more.  I’m still here, and I love you, but this tantrum is your job.”  Giving your child space to resolve his own turmoil is not the same as deserting him .   Do it in a way that lets him know you wish you could help.  But you and he know that your efforts to help will just prolong the tantrum. Firm limits will reassure him that he will not be dangerously out of control.

You can talk to your child’s health care provider about noticing and responding to triggers for temper tantrums and how to deal with them once they occur.

• I try to keep trips short but sometimes a longer one is inevitable. What can I do to deal with the tantrum that will likely happen?
• When we’re out in public and my child starts screaming I feel so embarrassed - how do I deal with temper tantrums in public?

Managing Temper Tantrums: Getting a Head Start at the 15 Month Visit (AAP)

Managing Temper Tantrums: Getting a Head Start at the 15 Month Visit (Mayo Clinic)

Why Kids Have Tantrums (KidsHealth)

Growth Milestones: 15 months (KidsHealth)

American Academy of Pediatrics (AAP). Aggressive Behavior. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/pages/Aggressive-Behavior.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

The second year of your child’s life is marked by incredible development and a constant need for independence and exploration.  With this can come mood shifts, frustration (on both you and your child’s part), temper tantrums and negativism.  From now on, your toddler will want to make his own choices.  You might find yourself asking, “is he hearing me but just doesn’t care?”  Many of the times when he’s acting rebellious or as if he’s not hearing, he is trying hard to sort out his own reactions and must use all of his energy to conquer his own feelings.  It is a difficult time for parents, for you might feel he is just out of control or that he is aiming his negativism at you.  The difficult job for you is to sense when he is working on these inner adjustments, and when he recognizes his rebellious feelings and may need firm discipline.

The spurt toward independence carries with it a kind of energy for exploration and learning about the world that is truly remarkable.  Your child has an intense need to try everything out for himself , whether he’s ready or not, and your efforts to keep up with him and keep things under control can be frantic.  You will sometimes wonder who is calling the shots and when you begin to express your need for control, he will respond with negativism and resistance.  Do not feel like a failure – this is a normal part of development!  Constant reorganization to find a new way to handle your resistant child is the story of parenting in the second year.  Distraction and diversion are your friends.

Throughout his second year, your child will swing back and forth constantly between fierce independence and clinging to you. Now that he can walk and do things for himself physically, he has the power to move away from you and test his new skills. But at the same time, he’s not yet entirely comfortable with the idea that he’s an individual, separate from you and everyone else in the world. Especially when he’s tired, sick, or scared, he’ll want you there to comfort him and fend off loneliness.

Some people call this period the first adolescence. It reflects some of your child’s mixed feelings about growing up and leaving you, and it’s absolutely normal. Remember that the best way to help him regain his composure is to give him attention and reassurance when he needs it. Snapping at him to “act like a big boy” will only make him feel and act more insecure and needy.

You might also notice “shifting attachments.”  For example, your child will almost always treat each parent or caregiver differently.  He will be hardest on the parent that he can count on the most, the parent that is the most available in his life.  He may treat the other parent or caregiver like someone special, particularly if this parent is around less.  This is normal and is an important part of your child testing out strong attachments.

This second year of life also highlights differences among toddlers.  The quiet, watchful ones become even more observant and sedentary, in contrast to active, intense children who are always moving.  Parents can become concerned by these differences but there is no cause for alarm and you should relish the individuality of your own child.  Don’t be concerned with comparing your child to other children or trying to mold him into the “ideal” child.

You can talk to your child’s health care provider about his moods and emotions.

• My child seems to swing from fierce independence to being very clingy – is this normal and how should I deal with it?
• It seems like my child favors my partner which is frustrating given I spend the most time caring for him , is this normal and does he really like my partner better?

Emotional Development: 1 Year Olds (AAP)

Growth Milestones: 15 Months (AAP)

Communicating with Baby: Tips and Milestones from Birth to Age 5 (NAEYC)

Managing Temper Tantrums: Getting a Head Start at the 15 Month Visit (Mayo Clinic)

American Academy of Pediatrics (AAP). Emotional Development: 1 Year Olds. Retrieved 4/1/2010 from http://www.healthychildren.org/English/ages-stages/toddler/pages/Emotional-Development-1-Year-Olds.aspx

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

At this age toddlers are just starting to learn what they should and should not do and guidance and discipline become very important in his second year of life.  However, it must be seen as a long-term teaching project.  Understanding your child’s need for learning limits is the most important step for parents and caregivers and is the basis for discipline decision. 

It is important to have realistic expectations for your child’s behavior and know that he learns from trial and error.  A child at this age will respond to your redirection but will likely repeat the action. This is not an act of disobedience, just natural curiosity and exploration.  You won’t be able to force your child to act exactly as you want and you are bound to have moments that he is just plain unruly.

Discipline should be a teaching effort, not a punishing one. It should be focused on important undesirable behaviors so that your strategies are more meaningful when you use them. Below are a few tips and strategies for guiding and disciplining your child:

• Give your child lots of praise for good behavior and for things you want to encourage.
• When he’s doing things you don’t like, or that might be dangerous, try brief explanations - “Don’t pull the kitty’s tail; that hurts the kitty.” When you see your child approaching an unsafe situation, remove him , and say "NO" firmly. Give priority to enforcing the limits that keep him safe.
• Try distracting your child away from an unwanted behavior or activity – for example, remove the hammer he’s been pounding incessantly and hand him a new toy.  Reading to your child is a great distraction. He wants to be near you and hear your voice.
• Eliminate as many temptations as possible; he needs freedom to explore in an area that is not filled with a number of “no, no’s.”
• If things are really getting out of hand, you might want to try a brief time-out (1 to 2 minutes). Keep discipline brief and positive. A child won’t understand a long scolding or a long time-out. Spanking, shouting, and long explanations are not the best ways to teach your toddler.
• Try a class or group. Parenting classes and parent support groups are great places to learn. You might also check out books and pamphlets or call a parenting advice hotline in your community

You can talk to your health care provider about ways to guide and discipline your child.  Your child’s health care provider can help you identify strategies that match your child’s temperament and style of learning.

• I was spanked as a child and I grew up fine. What is wrong with spanking my child?
• How long is an appropriate for a time-out for a 15-month-old? Should I stay with my child during a time-out or should he be out of sight?

Discipline Tips: Key Messages for Parents (AAP)

Bring Out the Best in Your Children (AAP)

Guidance Resources for Families (Zero to Three)

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Young children who are just “learning the rules” of behavior may be confused if different caregivers expect different things. Parents don’t always agree about how to raise children. Your own experiences growing up often affect the choices you make today. Some of what you do with your child will be the same as what your parents did; some will be much different.  Deciding the best way to raise and discipline your child is often a point of disagreement between parents. Others who care for your child will also have ideas about guidance, behavior, and discipline. However, having similar limits and strategies for dealing with unwanted behaviors is ideal for helping a child learn and can help reduce problem behaviors.

Talking about the guidance and discipline strategies to use with a child is best done before a situation arises.  In order to make sure you are on the same page as other parents and caregivers, make a point of discussing guidance and discipline strategies on a relatively regular basis given your child’s behaviors and needs change as he grows.  You can come up with similar strategies to keep your child from doing unwanted behaviors, such as distracting him with a new book, toy, or something interesting out the window.  You can also decide on effective ways of dealing with those behaviors if they do happen. You can also clarify specific strategies that you do not want used, like spanking or shouting. Raise these topics with others who care for your child – and make sure they know your parenting style and values.   

You can talk with your child’s health care provider about why consistent discipline strategies are important and about ways to assert your preferences to family members and other caregivers.

• My partner was spanked as a child, but I don’t think that is a good way to discipline. How can we work out our differences?
• Everybody does things a little bit differently – how much difference is too much for our toddler?
• My partner was spanked as a child, but I don’t think that is a good way to discipline. How can we work out our differences?

Parenting Conflicts (AAP)

The Importance fo Schedules and Routines (Head Start)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Oral health is important for healthy teeth and gums, of course, but it’s also important for a child’s overall health.  By the first year, or soon after the first tooth erupts, your toddler should have his first dental visit and begin to establish a “dental home.” A dental home is a consistent place a child goes to for regular visits.  Some children, even by 12 to 15-months of age, already have dental problems that need to be addressed.
 
A dental home will be the beginning of an ongoing relationship between the dentist, your toddler and you. It will provide comprehensive dental care and will be accessible, coordinated and family-centered. It will provide information to you on ways to keep teeth and gums healthy, including advice about foods to encourage and those to avoid. The dentist will assess and plan for any special dental needs your child has. The dentist will also discuss how to handle any dental emergencies that come up and will offer referrals if needed. 

While some dentists may say that your child can come in when your child is a bit older for his first dental check-up, the American Dental Association, the Academy of General Dentistry and the American Academy of Pediatric Dentistry all encourage families to establish a dental home by one year of age.

You can talk to your child’s health care provider about your child seeing a dentist and good oral health.

• My toddler has only a few teeth – does he really need to go to the dentist this soon?
• Do I need to bring my toddler to a special pediatric dentist or will my family dentist be okay?
• I called my dentist office and they said my child does not need to come in at this age, is this true and why the different recommendations?

A Healthy Smile for Your Baby (MCH Oral Health)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Oral health is key to your child’s overall health.  You have the knowledge and dexterity to clean your child’s teeth thoroughly. Most children are not able to brush their teeth well independently until they are about 4-years-old. A general rule of thumb: Until he’s old enough to tie his own shoe, he’s not coordinated enough to brush his own teeth.  In the meantime, your child will certainly want to “help” brush and it’s good to encourage and teach, but you need to continue to be the one responsible for this task (But do reinforce your toddler’s beginning efforts!).  Habits learned early will carry over throughout your child’s lifetime. 

For your 15-month-old, use a soft toothbrush with plain water to clean his teeth and gums twice a day- after breakfast and before bed. Start by using fluoride-free toothpaste. When your child is able to spit and not swallow the toothpaste (usually around 2 to 3 years old), you should continue brushing his teeth using a pea-sized amount of fluoride toothpaste.

You can talk to your child’s health care provider about brushing his teeth. 

• My child hates having his teeth brushed. How can I make it more enjoyable for him ?
• My child insists on grabbing the toothbrush and trying to brush his own teeth. How can I encourage this healthy habit yet get his teeth and gums clean at the same time?
• When do I start using toothpaste? Why is non-flourinated toothpaste recommended?

A Healthy Smile for Your Young Child (MCH Oral Health)

Caring for a Young Child's Teeth (AAP)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

More than a quarter of young children have been found to have cavities. Something many parents may not be aware of is that the bacteria that cause tooth decay (cavities) can pass from a parent or caregiver to the child through saliva (spit). It is especially important for parents to brush and floss daily and see a dentist regularly – this goes for anyone who is in close contact with your child. Maintaining your own oral health not only sets a good example for your child, but also improves his chances for good oral health as well.

It's important not to clean a pacifier, spoon or anything that goes in the child's mouth in your mouth – use clean water instead. Whether or not your child's teeth are showing – they're growing beneath the surface. Avoiding cavities and the infections that cause them is important- especially since they are preventable. Keep your child's mouth clean by gently brushing the gums and teeth with water and a soft infant toothbrush or gauze.

You can talk with your child's health care provider about avoiding spreading bacteria that cause cavities to your child.

• My children often share straws and spoons. Could this be a problem?
• Why can’t I clean my child’s pacifier with my mouth?
• Can bacteria or germs from my mouth cause cavities in my child’s teeth later?

A Healthy Smile for Your Baby (MCH Oral Health)

A Healthy Smile for Your Young Child (MCH Oral Health)

How to Protect Your Baby's Teeth from Cavities (AAPD)

Keeping Your Child's Teeth Healthy (KidsHealth)

Center for Disease Control and Prevention (CDC). Oral Health - Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers: At A Glance 2010. Retrieved 4/1/2010 from http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Finger sucking, pacifiers and bottles can all negatively impact your child’s teeth and oral health.  If your child still drinks from a bottle, offer only water in the bottle. Most pediatricians recommend that the bottle start to be weaned, or given up completely by 18-months. Parents should avoid the habit of using a bottle to comfort a child who has trouble falling asleep, who wakes at night, or wants it as a comfort.  The milk, juice and formula inside a baby bottle are prime enemies of your toddler’s teeth. The sugar in these drinks can cause tooth decay (cavities). If your child still demands a bedtime or naptime bottle, give him one with just water in it.

If a child sucks strongly on a pacifier, his thumb or his fingers, this habit may affect the shape of his mouth or how his teeth are lining up (his bite).  However, if a child stops using a pacifier or finger sucking by 3 years of age, his bite will most likely correct itself.

You can talk about the use of bottles and its impact on your child’s teeth with your child’s health care provider.

• My toddler likes to go to sleep with a bottle of milk. Is it okay to change it to water?
• Will finger sucking, pacifiers or bottles cause my child’s permanent teeth to be crooked?
• Why should I limit my child’s juice intake – I thought fruits were good?

A Healthy Smile for Your Young Child (MCH Oral Health)

Feeding From a Bottle (CDC)

American Academy of Pediatrics (AAP) Bright Futures. Your Toddler’s Teeth: A Smile for the 15 Month Visit. Retrieved 4/1/2010 from http://www.healthyfuturesva.com/Text.aspx?html=v10_teeth&type=snapshot

Brazelton, Terry and Sparrow, Joshua. Touchpoints: Birth to Three, 2nd Edition. Massachusetts: Da Capo Press, 2006.

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

As your child gets older, he can move more quickly, climb higher and get away from you faster than you thought possible.  At 15-months, your child thinks he can do more than you will think is safe!  No matter how safe you think your house is, children this age need constant watching, unless they are in a playpen or crib.

Plan ahead to minimize potential dangers.  A 15-month-old who is able to move around on his own can get into, onto and around things that might not be safe. Parents and caregivers have to keep an eye on these toddlers, but also try to make your home and other play areas, inside and out, as safe as possible.  This includes grandparents’ homes or anywhere your child visits. Try getting down on your child’s level to see if there are dangers you may have missed.

Teach your child the meaning of the word "hot." Use the back burners on the stove, and turn handles toward the back. Prevent falls by using gates at the tops and bottoms of steps. Watch closely when he is going up or down the steps. To prevent your child from falling out of a window, keep furniture away from windows and install window guards that can open easily in case of a fire.

If a poisoning occurs or if your child swallows something he should not have, always call the POISON CONTROL CENTER at (800) 222-1222 first! Currently, Syrup of Ipecac is not recommended. When outside, hold on to your toddler whenever you are near streets, parking lots and driveways, even in quiet neighborhoods. Make sure there is sand, woodchips, or other soft surfaces under outdoor play equipment.
 
There are many tips for childproofing for a toddler on the move in the resources below and you can also talk to your child’s health care provider about this.

• My toddler loves to climb on furniture. I try to keep an eye on him , but I’m afraid he is going to get hurt. What can I do?
• My parents want to take care of my toddler while I work, but their house has a lot of things that I don’t think are safe for a 15-month old. Is there a checklist I could give them?

The 15 Month Visit: Keeping Up with Safety (Healthy Futures)

Home Safety: Here's How (AAP)

Safety Outside (KidsHealth)

Childproofing Your Home (NSC)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Shelov, S., & Hannemann, R. (Eds.). Caring for Your Baby and Young Child: Birth to Age 5 ( 4th ed.). New York: Bantam Books, 2004.

• I recently heard that national experts are saying that I should keep the seat rear racing for as long as possible and not necessarily turn it around when my child is one years old and 20 pounds. Why are the recommendations changing?
• I have trouble making my child stay in his car seat when we go do errands. He hates being buckled in and I hate bribing him . What can I do?
• My child is very big for his age and there are varying instructions to follow, how do we determine the best instructions to follow?
• My child has a special need and doesn’t fit in a regular safety seat – as he grows, who can help us figure out the best one to use?

Car Safety Seats: Information for Families for 2012 (AAP)

American Academy of Pediatrics (AAP). Car Safety Seats: Information for Families for 2010. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families-2010.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Tombrello, S. When should my child switch from a car seat to a booster seat? Retrieved 4/1/2010 from http://www.babycenter.com/404_when-should-my-child-switch-from-a-car-seat-to-a-booster-sea_1384636.bc

Do not start your vehicle until everyone is buckled up – children watch everything their parents do and love to copy them so it is important for you to model safe behaviors by always wearing your safety belt. The best way to get your child to accept car seats as a natural way to travel is to use your seatbelt yourself every time you are in a car. Your good habits keep everyone in the car safer.

You can talk to your child’s health care provider about setting a positive example for your child by always using your seat belt.

• On short trips I might not use my seat belt but I do put the baby in his car seat. Isn’t that good enough?
• What can I say that will convince my parents to wear their seat belts when they have my child with them?

Encouraging Seat Belt Use (National Safety Council)

Seat Belts for Kids (SafeKids)

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Many substances that seem safe can be dangerous for children, including soaps, shampoos, pet products and medicines. A safe home means one where your child can’t reach foods or cleaning agents that could be dangerous for him . You can lock or block cabinets where you keep unsafe products or move them to high cabinets instead of keeping them under the counters. Be aware that many of these items come in colorful containers that may attract your child.

If you suspect that your child has swallowed something poisonous, FIRST call the National Poison Control Center at 1-800-222-1222 and follow their instructions.  (The Poison Control Center should be called before your child’s doctor’s office when you are concerned about what is poisonous). Syrup of Ipecac is no longer recommended nor is anything else to induce vomiting.

Some plants are poisonous, so avoid them or make sure they’re out of reach.  If you are unsure about any of the plants in your house or yard, call your local Poison Control Center (1–800–222–1222) and request a list of poisonous plants common to your area. If you have any poisonous plants, either replace them or securely fence and lock that area of the yard away from your child.

You can talk to your child’s health care provider about what you should do if your child swallows poison.

• If I think my child has eaten or drunk something I am not sure is safe should I call you or the poison control center?
• Should I make my child vomit if he drinks something dangerous?

Tips for Poison Prevention and Treatment (AAP)

The National Poison Control Hotline (Home Safety Council)

Tips to Prevent Poisonings (CDC)

https://www.poison.org/

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.

Your toddler is just learning that objects can be hot. But he still doesn’t understand that he can get burned. Protect him by taking these steps:

• Don’t leave heavy objects or hot liquids on a table with a tablecloth. Your child could tug on the cloth and cause the object to fall on him .
• Turn panhandles toward the back of the stove.
• Keep your child away from
• Hot stoves
• Fireplaces
• Irons
• Curling irons
• Space heaters
• Small appliances
• Electric cords.

Fire Safety:
One of the most important steps you can take to protect your family against fire is to install smoke alarms and keep them in good working order. You can buy smoke alarms at most home and hardware stores, and they often cost $10 or less. Check with your fire department to see if they give out and install free smoke alarms.

• Install smoke alarms outside every bedroom or any area where someone sleeps. Also install them in furnace areas. Be sure there is at least 1 alarm on every level of your home, including the basement, or at each end of a mobile home. 
• Place smoke alarms away from the kitchen and bathroom. False alarms can occur while cooking or even showering.
• Test smoke alarms every month by pushing the test button. It is best to use smoke alarms that have long-life batteries, but if you do not, change the batteries at least once a year, such as when you change your clocks in the fall. 
• Replace smoke alarms every 10 years.
• Never paint a smoke alarm.
• Clean (dust or vacuum) smoke alarms once a month. 
• Use smoke alarms equipped with a flashing light and an alarm in homes with children or adults who are hard of hearing or deaf. 1

Fire Drills - Be Prepared! 

• Have an escape plan and practice it with your family. Determine when (immediately) and how you will grab your 15-month-old and continue out. This will help you and your family reach safety when it counts. When a fire occurs, there will be no time for planning an escape. 
• Draw a floor plan of your home. Discuss with your family 2 ways to exit every room. Make sure everyone knows how to get out and that doors and windows can be easily opened to permit escape. If you live in an apartment building, never use an elevator during a fire. Use the stairs!
• Agree on a meeting place. Choose a spot outside your home near a tree, street corner, or fence where everyone can meet after escaping. 
• Practice, practice, practice. Practice your exit drill at least twice a year (including how/when you grab your 15-month-old). Remember that fire drills are not a race. Get out quickly, but calmly and carefully. Try practicing realistic situations. Pretend that some exits or doorways are blocked or that the lights are out. The more prepared your family is, the better your chances of surviving a fire. 

You can talk to your child’s health care provider about fire safety.

• Should I buy an escape ladder for our house since we sleep on the second floor?
• My partner smokes and I worry about cigarettes and matches left around. How can I encourage my partner to stop smoking?
• My child with special needs isn’t easy to carry with all his equipment – should I let the emergency folks know before there’s an emergency?

Fire Safety (AAP)

Fire Prevention Tips (Home Safety Council)

Fire Safety (NSC)

Keeping Kids Safe From Fire (USFA)

American Academy of Pediatrics (AAP). Fire Safety. Retrieved 4/1/2010 from http://www.healthychildren.org/English/safety-prevention/all-around/Pages/Fire-Safety.aspx

Hagan JF, Shaw JS, Duncan PM, eds. 2017. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. Elk Grove Village, IL: American Academy of Pediatrics.